Chahine Assi1, Jad Mansour1, Camille Samaha1, Sleiman Ajjoub1, Kaissar Yammine2. 1. Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Zahra Street, Achrafieh, Beirut, Lebanon. 2. Department of Orthopedic Surgery, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Zahra Street, Achrafieh, Beirut, Lebanon. cesaryam@gmail.com.
Abstract
OBJECTIVES: Antegrade intramedullary nailing (AIMN) using 2k-wires seems to be superior to other modalities in treating displaced fractures of the fifth metacarpal neck (FFMN). Few reports demonstrated similar results retrospective with a single k-wire. The aim of the study is to describe our single k-wire technique and evaluate the related results. METHODS: This is a retrospective study of a continuous series of patients treated with a single intramedullary k-wire for FFMN. It includes 30 patients who met the criteria for surgery: a dorsal angulation of more than 30°, malrotation, or both. The mean clinical follow-up period was 7 ± 14.9 months. RESULTS: The mean pre-operative angle was 50° ± 11.35° and the mean immediate post-operative angle was 4.86° ± 2.8°. The mean immediate correction was 47° ± 9.3°. The mean correction at last follow-up was 45.14° ± 8.55°. Healing was obtained in all patients and bone union was achieved at a mean of 5.6 ± 1.2 weeks. The mean operative time was 8.5 min. The mean C-arm usage (number of clicks) was 7.2 times. The mean exposure radiation time was calculated at 3.6 s. The mean radiation dose was 0.08 mGy/mm2. The mean satisfaction score was 1.26 ± 0.45. Quick-DASH and EQ-5D scores yielded excellent values. CONCLUSIONS: With potential benefits like lesser surgical time, radiation and cost, the use of a single AIMN could be safer, quicker and cheaper while reproducing similar clinical, functional and radiological outcomes to those reported with the use of 2k-wires.
OBJECTIVES: Antegrade intramedullary nailing (AIMN) using 2k-wires seems to be superior to other modalities in treating displaced fractures of the fifth metacarpal neck (FFMN). Few reports demonstrated similar results retrospective with a single k-wire. The aim of the study is to describe our single k-wire technique and evaluate the related results. METHODS: This is a retrospective study of a continuous series of patients treated with a single intramedullary k-wire for FFMN. It includes 30 patients who met the criteria for surgery: a dorsal angulation of more than 30°, malrotation, or both. The mean clinical follow-up period was 7 ± 14.9 months. RESULTS: The mean pre-operative angle was 50° ± 11.35° and the mean immediate post-operative angle was 4.86° ± 2.8°. The mean immediate correction was 47° ± 9.3°. The mean correction at last follow-up was 45.14° ± 8.55°. Healing was obtained in all patients and bone union was achieved at a mean of 5.6 ± 1.2 weeks. The mean operative time was 8.5 min. The mean C-arm usage (number of clicks) was 7.2 times. The mean exposure radiation time was calculated at 3.6 s. The mean radiation dose was 0.08 mGy/mm2. The mean satisfaction score was 1.26 ± 0.45. Quick-DASH and EQ-5D scores yielded excellent values. CONCLUSIONS: With potential benefits like lesser surgical time, radiation and cost, the use of a single AIMN could be safer, quicker and cheaper while reproducing similar clinical, functional and radiological outcomes to those reported with the use of 2k-wires.
Entities:
Keywords:
Fifth metacarpal neck fracture; Single antegrade elastic nailing; Surgery